Background: Electroconvulsive therapy (ECT) is effective for treatment-resistant depression and leads to short-term structural brain changes and decreases in the inflammatory response. However, little is known about how brain structure and inflammation relate to the heterogeneity of treatment response in the months following an index ECT course.
Methods: A naturalistic six-month study following an index ECT course included 20 subjects with treatment-resistant depression. Upon conclusion of the index ECT course and again after six months, structural magnetic resonance imaging scans and peripheral inflammation measures [interleukin-6 (IL-6), IL-8, tumor necrosis factor (TNF-), and C-reactive protein] were obtained. Voxel-based morphometry processed with the CAT-12 Toolbox was used to estimate changes in gray matter volume.
Results: Between the end of the index ECT course and the end of follow-up, we found four clusters of significant decreases in gray matter volume ( < 0.01, FWE) and no regions of increased volume. Decreased HAM-D scores were significantly related only to reduced IL-8 level. Decreased volume in one cluster, which included the right insula and Brodmann's Area 22, was related to increased HAM-D scores over six months. IL-8 levels did not mediate or moderate the relationship between volumetric change and depression.
Conclusions: Six months after an index ECT course, multiple regions of decreased gray matter volume were observed in a naturalistic setting. The independent relations between brain volume and inflammation to depressive symptoms suggest novel explanations of the heterogeneity of longer-term ECT treatment response.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1017/S0033291722003555 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Case of Asymmetric Seizure Termination During an Acute Course of Right Unilateral Electroconvulsive Therapy.
J ECT
January 2025
From the Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH.
Electroencephalogram (EEG) monitoring during electroconvulsive therapy (ECT) is commonly done using a 2-channel EEG in order to capture activity from both brain hemispheres, though many institutions may instead opt to utilize a 1-channel EEG, often for reasons of convenience. We present a novel case of asymmetric termination of EEG seizure activity during an acute course of right unilateral ECT, prompting a full neurological workup to investigate potential underlying structural or physiological causative factors. This case assists in informing the necessity of bilateral hemispheric EEG monitoring as well as highlights the importance of searching for undiagnosed or latent neurological dysfunction in certain clinical situations arising during ECT.
View Article and Find Full Text PDFAutoimmune Encephalitis in Catatonic and Treatment-Resistant Psychotic Patients Referred to Electroconvulsive Therapy: Two Case Reports and Systematic Review.
J ECT
December 2024
From the Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.
Autoimmune encephalitis (AE) tends to manifest as a mixture of neuropsychiatric and somatic symptoms, either of which may predominate, and often shows a progressive clinical course sometimes leading to life-threatening conditions. Catatonic and psychotic syndromes, regardless of whether associated with dysautonomia, are common manifestations of AE, especially concerning the anti-NMDAR subtype. Several autoantibodies targeting different neuronal epitopes have been linked to specific clinical manifestations and their detection is embedded in some of the diagnostic criteria for AE.
View Article and Find Full Text PDFNeuromodulation Strategies in Lifelong Bipolar Disorder: A Narrative Review.
Behav Sci (Basel)
December 2024
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazza Aldo Moro, 100165 Rome, Italy.
Bipolar disorder is a debilitating psychiatric condition characterized by recurrent episodes of mania and depression, affecting millions worldwide. While pharmacotherapy remains the cornerstone of treatment, a significant proportion of patients exhibit inadequate response or intolerable side effects to conventional medications. In recent years, neuromodulation techniques have emerged as promising adjunctive or alternative treatments for bipolar disorder.
View Article and Find Full Text PDFCatatonia-asossicated urinary retention in geriatric patients: a case series report.
BMC Geriatr
December 2024
Faculty of Medicine, Department of Geriatric Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Article Synopsis
- Catatonia is a neuropsychiatric condition often overlooked in elderly populations, leading to serious complications like urinary retention, which can exacerbate mobility issues and infection risks.
- The study followed four elderly patients (ages 66-84) with severe depression and catatonia, all showing significant urinary retention at admission.
- After receiving electroconvulsive therapy (ECT), the patients saw improvements in catatonic symptoms and a dramatic reduction in urinary retention, highlighting ECT's effectiveness in treating both conditions.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!